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Defining ASD, Intellectual Disability and Developmental Disability.

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Defining ASD, Intellectual Disability and Developmental Disability.

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ASD: Autism Spectrum Disorder may lead to issues concerning social interactions, behaviors(mood swings, self-injurious), poor fine or motor skills, impairments with speech or learning and the need to exert sensory desires.
Intellectual disability: an individual will show signs of impaired cognitive functioning, delayed development or behaviors. Typically seen as a symptom of another diagnoses.
Developmental disability: impairments with physical, learning or behavioral areas. These conditions begin during the developmental period of an individual and can cause difficulty in daily functioning.

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-No known specific causes
-Researchers have narrowed it down to believing genetics, neurological structure and development/environmental factors.
-Have not found specific genes linked to it.
-Many individuals with ASD develop epilepsy which correlates with neurological structure.

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-Functional impairments
-Fine and motor movements
-Deficits in social settings

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-Epilepsy
-Sleep disorders
-Cognitive impairment
-Anxiety and Depression
-Self-injurious behaviors

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-Early intervention can help because many children's symptoms improve with age.
-Specialized programs involving social skills or behavioral aspects.
-Recreational therapy to familiarize one with group play, loud settings, problem solving or physical health.

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-Abnormalities in genetic material
-Drug or alcohol use during pregnancy
-Premature birth
-Head injuries as an infant like shaken baby syndrome
-Malnutrition or disease as a child

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Effective recreation therapy for intellectual disability 

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Effective recreation therapy for intellectual disability 

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-Community integration
-Physical exercise
-Activities to address daily living(ex. brushing teeth)

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Importance of timing(congenital vs acquired)

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Importance of timing(congenital vs acquired)

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Congenital: when the individual is diagnosed with impairment at birth
Acquired: when someone is diagnosed later on in life
This is important because it can affect an individual’s personality and social depending on their age.  For children, it can be hard creating relationships and some find it embarrassing to wear a hearing aid but when you lose your hearing as you get older, it can take you away from friends and socializing.

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-noise, aging, disease, heredity
-certain illnesses or medications
-infections during pregnancy or complications during birth
-abnormality in ears, brain, or auditory neural pathways

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Types:
-Conductive
-Sensorineural
-Mixed
-Auditory neuropathy spectrum disorder
Degrees:
-Mild
-Moderate
-Severe
-Profound

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Visual acuity is how visual impairment is described so having 20/40 vision or less. This can cause one to not be able to obtain a driver’s license or have lowered peripheral vision.

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-diseases
-physical injury to eye
-abnormal body functions that cause injury(glaucoma)
-structural differences in the brain

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Hearing:
1. In a small group, create programs that will help your client transition to a community setting more easily.  Setting them up with the tools they need to join groups or show them resources in the community they can use for recreation.
2. Create a program involving sign language to continually help them improve on this aspect if they want or are trying to learn this language.
Visual:
1. Create programs to advance their functional skills including problem solving, orientation and self-care.

2. Even more so TR related, we can supply clients with the information to participate in recreation.  Which means assisting them with transportation, equipment and make sure they care participate safely.

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-Affects whole body starting with arms and legs then affecting brain, throat, heart, diaphragm, etc.
-more likely to affect males
-DMD is fatal

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-Involves neurological problems with the brain
-Palsy signifies having muscle problems or weakness
-Muscle weakness is due to damage to certain areas of the brain
-Effects vary from person to person
-Physical and cognitive impairments can be a result
-Spastic CP: certain limbs affected, muscles can be permanently contracted, common
-Athetoid(dyskinetic) CP: uncontrolled movements, usually in extremities and face, low muscle tone, less common
-Ataxic CP: poor coordination, balance and depth perception affected, more rare
-Mixed: combination of any of the above types

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Symptoms:
-poor muscle coordination
-poor muscle control
-tight muscles
-drooling
-difficulties eating/swallowing
-speech impairment
-difficultly with fine motor skills
-tremors
Causes:
-genetics
-infections
-abnormal brain development
-lack of oxygen
-seizures
-breech position during birth
-premature birth or low weight birth
-New research is showing a link between CP and abnormalities with placentas

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-Intellectual disability: affects 40-67% of children with CP
-Epilepsy: affects 35-50% of those with CP causing seizures
-Behavioral problems: about 25% affected, ADHD, oppositional defiance disorder
-Learning disability: 40% of those diagnosed affected
-Sensory impairments: 15-62% affected with vision or hearing impairments
-Feeding difficulties: some need gastric tube, sucking problems, swallowing issues
-Lung problems: 33% experience pulmonary infection
-Chronic pain: about 28% of adults have back, foot, ankle, knee, shoulder pain and headaches

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Recreational terapy interventions for CP

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Recreational terapy interventions for CP

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-exercise: for those with CP it is important to maintain muscle strength, endurance and flexibility. You can do this by stretching, working out with weights, range of motion activities and hand-eye coordination games.
-aquatic therapy: improves physical and respiratory functioning. Improves balance, coordination, gross motor movements and more.  Swimming relieves pain on the body and stress which improves mood and can reduce anxiety.
-hippotherapy: use of a horse as a form of treatment. Can improve head, neck, and torso control. Promotes relaxation, can reduce stress and increase motivation
-massage therapy: alternative medicine used to reduce pain, manipulate muscles, and enhance well-being.

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dyplegia: only legs are impacted
hemiplegia: both limbs on one side of the body
quadriplegia: upper and lower extremities affected
ataxia: no control over body movements
dysarthria: speech impairment involving articulation
spasticity: condition when certain muscles are continuously contracted
contractures: shortening/hardening of muscles or tendons which result in rigidity joints
osteopenia: reduced bone mass

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-happens because of damage, disease or a disorder
-interrupts communication to brain
-results in loss of movement or sensation

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-MME scores injury
-Normal: 100% functionality, complete range of motion with resistance
-Good: 75% functionality, complete range of motion with some resistance
-Fair: 50% functionality, complete range of motion with no resistance just gravity
-Poor: 25% functionality, complete range of motion when given supports reducing resistance and gravity
-Trace: 10% functionality, evidence of contractility
-Zero: 0% functionality, no evidence of contractility

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-incomplete: some motor or sensory function below point of injury
-complete: no motor or sensory function below injury

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-Autonomic dysreflexia: increase in blood pressure that can be fatal
-Pressure ulcers: skin begins to die at a point where much pressure is being put on because low oxygen flow to that area
-respiratory complications: injuries to the upper body can compromise organs involved in breathing making it difficult to breath, cough, or swallow.

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-tetraplegia: upper and lower extremities affected(quadriplegia)
-paraplegia: paralysis of the lower body
-complete vs. incomplete injury: complete does not show signs of contractility whereas incomplete shows some
-autonomic dysreflexia: increase in blood pressure
-pressure ulcer: pressure sores causes from sitting in a chair a certain way for a long time. Oxygen does not reach area and skin dies

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a.     Pressure Ulcer:
-Tissue damage caused by unrelieved pressure on the skin

-Common in elderly individuals and nursing homes

- Most affected areas include elbow, hip, shoulder, heel, and back of head

b.     Incontinence:

-Control over urinary or bowel movements

-Measured using 5 categories: continent, usually continent, occasionally incontinent, frequently incontinent and total dependence(incontinent almost always)

-Considered to have incontinence if they are usually incontinent or higher on the scale

c.     Delirium:

-Deficit in attention and in other cognitive functioning areas

-Quickly develops(hours or days)

-Varies throughout diagnosis(has the possibility to improve)

d.     Dementia:

-Chronic cognitive disorder that impairs memory, personality and functioning

Can be caused by diseases, traumatic brain injury, or aging

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a.     Predominant age:

-Can notice symptoms around mid-50s(earlier if individual as an intellectual disability)

-Symptoms typically occurs as you age

-The earlier you find out you have the disease, the longer chance you have to live

b.     Causes:

-Genetics/hereditary

-Specific diseases can progress into Alzheimer’s

-Some studies suggest lifestyle and environmental factors will affect the brain over time

c.     Systems affected:

-Brain

-Nervous system

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a.     An umbrella term for two related diseases of NCD

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a.     Design programs that consider the individuals goals, personality, stage of disease, and cognitive/physical functioning level

b.     More importantly, create meaningful activities that incorporate the list above but address the interests of the patient.

c.     Make sure the activity is purposeful for the patient

d.     Be aware of the level of functioning needed so it does not upset the individual if they can come complete it

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a.     Financial

-Caregiving needed to support family member with disease is expensive

-Therapy desired for quality of life can be forgotten if family is not financially stable

-Family may be put under most stress if their income is not meeting financial needs, to offer the individual with the disease, the best care

b.     Emotional

-Having a sick family member emotional affects the rest of the family

-Stressed about how to offer as much support as possible

-Worried about their well-being

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PTSD: classified as an anxiety disorder for individuals that have been through or witnessed a traumatic event.
Causes:
-Traumatic injury or event
-Witnessing another person being injured or killed
-Sudden unexpected death of a loved one
-loss of a job or home
-Terrorist incidents
-Rape
-Other life threatening events

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-Affects the brain: cognitively(learning, focus) and
socially(communication, emotions)

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-Agoraphobia
-OCD
-Social phobia
-Major depressive disorder
-Somatization disorder
-Substance related disorders(drug, alcohol use)

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Five categories of symptoms for Schizophrenia

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Five categories of symptoms for Schizophrenia

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-Delusions: belief they cannot heal, someone wants to harm them, people are talking/plotting about them
-Hallucinations: vivid perceptions of something that is occurring in the real world. Many hallucinate while sleeping
-Disordered thinking and speech: impaired communication, switching topics frequently, giving answers to questions that don’t make sense, memory deficits, delayed recall, impairments in organizing information
-Motor behavior: Catatonia(resistance to instructions, rigid or bizarre postures, lack of response)
-Negative symptoms: show less emotions, less emphatic facial expression, lack of intonation in speech, less eye contact, fewer non-verbal movements, lack of motivation, asociality

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-Genetics
-Structure and chemical composition of the brain
-Environmental factors
-Psychosocial factors

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-Cognitive functioning: delusions, disordered thinking, speech, auditory hallucinations
-Emotional functioning: blunted or flatted effect, inability to experience pleasure
-Social functioning: inability to empathize with others, impaired communication

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-Hallucination: perception of something that is not present, can include all senses
-Delusion: belief that something is true or going to happen despite proof that it will not
-Psychosis: mental disorder that affects thoughts and emotions
-Anhedonia: inability to experience pleasure

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MDD: pervasive disorder, onset is triggered by situational factors, displays symptoms that are more severe than would be expected by such triggers.
Symptoms:
-depressed mood most of the day, nearly every day
-Diminished interest in most or all activities
-Significant increase or decrease in weight or appetite
-lack of sleep or sleeping excessively
-Easily agitated
-Sluggish
-Fatigue or loss of energy
-Feelings of guilt or worthlessness
-Recurrent thoughts of death

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-Brain: cognitive and emotional impairment
-Negatively impact relationships
-Disrupt daily activities
-Basic self-care can be neglected

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-Chronic pain
-Cardiovascular disorders
-Substance abuse
-Eating disorders
-Dementia
-Personality disorders

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-Excessive and uncontrollable worry about everyday things more days than not. Manifests in physical symptoms including muscle tension, sweating, nausea, gastrointestinal problems, jumpiness, fidgeting, trembling, inability to relax, etc.

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-Brain
-Mood
-Cognition
-Social functioning
-Appropriateness of emotion
-Interactions and relationships
-Respiratory system: shortness of breath, excessive sweating
-Cardiovascular system: heart palpitations

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Gambing disorder is an addictive disorder

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Gambing disorder is an addictive disorder

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-Follow a recovery program including numerous steps
-Compulsive issues
-Unable to stop even though having the desire to
-Participate in activity despite negative consequences
-Associated with health problems, social isolation, depression, suicidal thoughts or suicide

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-Behaviorally conditioned problem gambler: Lose but believe they are able to get their money back, cognitively believe they have control over winning, and experience anxiety, depression and substance abuse.
-Emotionally vulnerable problem gambler: similar conditions as behaviorally conditioned group but they had pre-existing problems that made them vulnerable including anxiety, poor coping, problem solving skills, and negative family/life events.
-Antisocial, impulsive problem gambler: emotionally vulnerable group that is more likely to have predisposing psychological and biological factors, believed to have neurological and neurochemical dysfunctions, impulsive features, ADD and antisocial personalities.

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Systems affected:
-Interferes with occupation and social life
-Enquire chasing behaviors: taking greater risks to earn money back
-Cognitive processes become irrational
-Antisocial behaviors
-Emotionally difficulties
Secondary problems:
-Social/relationship difficulties
-Separation and divorce
-Occupational difficulties
-Criminal and antisocial behaviors
-Financial troubles
-Substance-related disorders
-Suicide

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-Anorexia nervosa: Refuse to maintain healthy body weight, fear of gaining weight, extreme concern with body weight/shape.
-Bulimia nervosa: Eating large quantities of food in short periods of time, no regard to feelings of hunger or fullness, feeling out of control while eating.
-Binge-eating disorder: Frequent episodes of eating large quantities of food in short periods of time and rapidly, feeling out of control while eating, feelings of shame, disgust or guilt after binge.
-Pica: Eating of nonfood or nonnutritive substances and not a social practice. (toys, dirt, etc.)

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-Genetics
-Biological issues
-Psychological or interpersonal issues
-Social issues
-Cultural issues

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-Social: withdrawn and socially isolated from family and friends
-Cognitive: denial of illness, body image issues, perfectionism, avoidance
-Emotional: anxiety, depression, decreased self-esteem/self-worth, expression issues or cope with anger
-Physical: dehydration, low blood pressure, osteoporosis, stomach/digestive complications, arrhythmias, and tearing of the esophagus

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-Cardiac arrhythmia
-Cardiac arrest
-Brain damage
-Osteoporosis
-Infertility
-Death

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-Familial, social, or cultural factors: substance use more likely when family, social, and/or cultural network models substance abuse or behaviors.
-Personality factors: substance use high in those experiencing depression, high levels of stress, or poor coping skills.
-Cognitive factors: substances that produce a positive effect become desirable and can reduce negative emotional states.
-Genetic factors: a person with a parent with history of substance abuse is at a greater risk.
-Biological factors: particular neurotransmitters affect the reward pathways of the brain and over time without the substance, the reward system can be difficult to simulate naturally.

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-Physical: illness, injuries, hyperactivity of the autonomic nervous system and physical damage to body
-Mental: anxiety, depression, loss of motivation, anger, agitation, and irritability
-Social: unhappy relationships
-Cognitive: short-term confusion, learning problems, and memory loss

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Secondary problems of substance disorders

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Secondary problems of substance disorders

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-Others affected: a person’s substance abuse may impact those around them, family, friends, co-workers, or classmates
-Dual diagnosis: many experience substance abuse along with mental health disorders

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-cerebrovascular accident is a disease that affects the arteries in and around the brain
-this affects the brain because a blood vessel that carries oxygen and nutrients to the brain ruptures or is blocked by a clot.
-because of the blockage, the brain does not receive all the oxygen needed to function

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F: face drooping- one side of a persons face is numb or droops
A: arm weakness- one arm is numb or weak
S: speech difficulty- having slurred speech or unable to speak
T: time to call 911- if any symptoms, get person to hospital

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-Left CVA: right hemiplegia, language deficits, slow and cautious behavior style
-Right CVA: left hemiplegia, visual deficits, quick and impulsive behavior style

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-blood clot in or around brain
-blood vessel ruptures
-hypertension
-heart disease
-high cholesterol
-smoking
-drug or alcohol use

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-lack of mobility
-poor coping mechanisms
-loss of function
-barriers to recreation and leisure choices
-decrease in independence and participation
-depression

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-Motor impairments: hemiplegia, motor planning, muscle power, muscle ton, reflexes, balance, and coordination
-Sensory impairments: decreased sensory awareness, numbness, tingling, agraphia and processing problems
-Cognitive impairments: decreases in consciousness functions, calculation abilities, attention, concentration, problem solving, organizing, perception, orientation, time management, planning, judgement, and safety
-Language impairments: dysphasia in comprehension, reading/writing, decrease in expression an reception of language
-Visual impairments: double vision, depth perception problems, and field cuts
-emotions/personality
-sexual function
-bowel and bladder function

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-from of acquired brain injury that occurs from a direct trauma to the brain

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-blast injuries: brain injuries caused by explosions
-acceleration-deceleration injury or shearing injury: caused when the body is traveling at a high speed and then comes to an abrupt stops(ex. car accident)
-penetrating injuries: injury to the brain that results from a foreign object penetrating the skull and entering the brain
-shaken baby syndrome: serious brain injury that occurs when an infant or toddler is forcefully shaken

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-physical changes: weakness, muscle tone, coordination problems, full or partial paralysis, balance difficulties, and fatigue
-cognitive changes: impairments in arousal and attention, initiation, memory, problem solving, judgement, organization, time management and abstract reasoning
-emotional and behavioral changes: difficulty with social skills, inappropriate or self-centered behavior, disinhibited behavior, irritability, frustration, depression, and anxiety

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-anoxic injury: absence of oxygen to the brain
-hypoxic injury: decrease in oxygen to the brain
-cranial nerve dysfunction: injury to cranial nerve(s)
-edema: swelling and excess fluid in the brain
-hematomas: collection or pooling of blood that can increase intracranial pressure

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Type 1: insulin dependent diabetes mellitus and juvenile-onset diabetes. Develops when the body's immune system destroys the pancreatic beta cells that make insulin.
Type 2: Non-insulin dependent diabetes mellitus and adult-onset diabetes. Most common form of diabetes. The body does not produce enough insulin or the bells cannot use the insulin properly so there is a build-up of glucose in the bloodstream.

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Type 1: caused by an autoimmune disease, predominantly hereditary. Environmental factors such as viruses, infections, and foods are thought to trigger reaction.
Type 2: caused by a combination of genetic, personal, and environmental factors. Hereditary plays a role or having a parent or sibling with T2D increases chances. Personal factors that increase the risk include obesity, being middle-aged, physical inactivity, high blood pressure and bad cholesterol.

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-Hypoglycemia: when your blood sugar becomes too low. Symptoms include shakiness, dizziness, sweating, hunger, headache, pale skin color, behavioral changes, or seizures.
-Hyperglycemia: when blood glucose becomes too high. Can be caused by injection of too little insulin or when the body is not using insulin effectively.
-Ketoacidosis: excess ketones and acidosis develop because of faulty carbohydrate metabolism. Develops slowly.
-Hypertension: High blood pressure
-Heart disease/stroke: leading cause of diabetes-related deaths. Adults with diabetes are twice as likely to have heart disease or a stroke.

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MS is an autoimmune disease that causes chronic inflammation of the central nervous system. The body's own defense system attacks the fatty substance, known as myelin, that surrounds and protects the nerve fibers of the brain, optic nerves, and spinal cord.

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-Relapsing-remitting: the most common type of MS. Symptoms flare up and then subside.
-Secondary-progressive: exacerbations become steadily progressive and only partial recoveries are achieved.
-Primary-progressive: a steady progression of symptoms without signs of remitting.
-Progressive-relapsing: a steady progression of symptoms with obvious acute attacks.

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-Blood vessel diseases: Narrowed, blocked, or stiffened blood vessels that impair circulation.
-Heart arrhythmias: abnormal heartbeat which can be quick, slow or irregular.
-Congenital heart defects: structural problems of the heart or major blood vessels. Often recognized in babies.
-Cardiomyopathy: thickening and stiffening of the heart muscle.
-Heart infections: pericarditis(infection of the tissue surrounding the heart), myocarditis(infection of the muscular middle layer of the heart walls), and endocarditis(infection of the inner membrane that separates the chambers and heart valves).
-Valvular heart disease: functions of one or more heart valves are damaged leading to stenosis, regurgitation or prolapse.

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Secondary problems related to heart diseases

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Secondary problems related to heart diseases

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-Physical disorders
-Cognitive disorders
-Developmental issues
-Anxiety
-Participation in activities

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Cancer is the generic name given to a group of more than 100 diseases where abnormal cells divide and grow out of control. These cells invade other parts of body creating more issues. The location where the cancer originates from dictates the name of the cancer.

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-Side effects from treatment: hair loss, sickness, etc.
-Surgery complications: pain, collapsed lung, blood clots, fatigue
-Other patients endure greater symptoms including physical restrictions, emotional stress and spiritual symptoms.

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-In situ: early cancer that is present only in layer of cells in which it began
-Localized: cancer that is limited to the organ in which it began without evidence of spread
-Regional: cancer that has spread beyond the original site to nearby lymph nodes or organs and tissues
-Distant: cancer that has spread from the primary site to distant organs or distant lymph nodes
-Unknown: describes cases for which there is not enough information to indicate a stage

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-COPD: is a condition that makes it difficult for one to breathe. This means a person's lungs are not working properly.
-Chronic bronchitis: chronic inflammation of the bronchial tubes with an increase in mucus and mucus secreting cells. The mucus obstructs the bronchioles, making it difficult to breathe.
-Emphysema: walls of the alveoli begin to break down and the lung loses it elasticity. Instead of small air sacs called alveoli, there are few large air sacs.

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-Smoking/secondhand smoke
-air allergens
-prolonged exposure to fumes/chemicals
-Gene mutation in some cases

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-limits physical and social activities including work
-makes one more susceptible to respiratory infections and pulmonary hypertension
-increased risk of lung cancer
-can lead to depression

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1st: swelling of the synovial lining, causing pain, warmth, stiffness, redness and swelling around joint.
2nd: rapid division and growth of cells which causes the synovium to thicken.
3rd: the inflamed cells release enzymes that may digest bone and cartilage, often causing the involved joint to lose its shape and alignment leading to increased pain and loss of movement.

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-Genetic factors: specific genes may play a role in whether a person develops RA and how severe the disease will become.
-Environmental factors: believed that an environmental factor, such as a virus, bacterium or mycobacterium may trigger the disease process.
-Hormones: deficiencies or changes in certain hormones may promote the development of RA in genetically susceptible clients who have been exposed to an environmental triggering agent.

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-musculoskeletal system
-sensory changes
-changes to other organs
-lower energy levels
-psychological issues
-primary affects any joints

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Define epilepsy and relationship with seizures

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Define epilepsy and relationship with seizures

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-Epilepsy is a medical condition that affects brain neurons and causes abnormal signals.
-Epilepsy may be caused by an imbalance of neurotransmitters or defects in the connections between neurons. When these abnormal transmitters cause a strong surge of electrical activity it is called a seizure.

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Difference between focal and generalized seizures

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Difference between focal and generalized seizures

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-Focal seizures(partial seizures): begin in a localized area of the brain and can be simple or complex which affects the human in different ways either a mild, barely noticeable change or may cause them to go unconscious.
-Generalized seizure: a result of abnormal neuronal activity that occurs in more than one area of the brain. These seizures may cause loss of consciousness, falls or muscle spasms.

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-potentially life-threatening condition in which a person either has an abnormally prolonged seizure or does not fully regain consciousness between seizures.

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Safety concerns for a person with epilepsy and a recreation activity for them 

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Safety concerns for a person with epilepsy and a recreation activity for them 

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https://www.telmenow.com/2016/01/living-with-epilepsy-your-stories/

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Substance-Related Disorders

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Clearly define the disability or illness

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Clearly define the disability or illness

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Substance-related disorders involve the use of substances in ways that can be harmful to the person taking the substance, other people in the person's life, and the person's community.  It can negatively affect every aspect of a person's mental health and everyday life.

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Causes
-family
-social influences
-cultural factors
-Personality characteristics
-Cognitive aspects(genetics)
-Biological factors
Symptoms
-Withdrawal: a set of unpleasant physical symptoms that are opposite of the effects of the drug
-Physical: illness, injuries, hyperactivity of the autonomic nervous system, damage to body
-Mental: anxiety, depression, loss of motivation, anger, agitation, irritability
-Social: strained or unhappy relationships
-Cognitive: short-term confusion, learning problems, memory loss
-Poor judgement
-insomnia

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-Two general approaches are abstinence and harm reduction
-Provide safe environment if having symptoms of withdrawal
-Therapy
-Occasionally medication

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-Huge impacts of people around the individual
-Dual diagnosis is not uncommon considering mental health factors play a huge role in symptoms
-Increased risk of developing ADHD

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-Having withdrawals requires medical treatment at times because it can be very harmful
-You live with many symptoms for life and the addiction